Lack of appropriate governance of HIPE may impact on its healthcare planning and funding role — HIQA

The review was undertaken in order to assess compliance with the information management standards for national health and social care data collections within HIPE, which is designed to collect demographic, clinical and administrative information on discharges and deaths from acute hospitals nationally.

The review makes nine recommendations that, if implemented effectively, will drive improvements in information management at HIPE. 

Ms Rachel Flynn, HIQA’s Director of Health Information and Standards, said: “The review found shortcomings in governance structures at HIPE that have the potential to impact on its crucial role in healthcare planning and funding. To ensure that HIPE can fulfil its essential role, it is important that the HSE implements the nine recommendations made by HIQA today.”

HIPE was transferred from the Economic and Social Research Institute (ESRI) to the HSE in 2014. Within the HSE, certain responsibilities for HIPE have been devolved to two separate divisions, namely, the National Finance Division (specifically the HPO function) and the Acute Hospitals Division.

Ms Flynn continued: “Since its transfer from the ESRI to the HSE in 2014, there is little evidence from this review to demonstrate that HIPE has been effectively embedded into the National Finance Division and Acute Hospitals Divisions structures and also into the wider governance structure of the HSE. In the absence of clear governance arrangements, effective risk management and performance management have been limited, posing potential challenges to the overall functioning and use of HIPE.

“In particular, this review found that there are no national oversight structures and arrangements in place for the governance, leadership and management of HIPE at a senior level within the HSE. Furthermore, the review found that there is no forum at the national level to regularly review and monitor the range of governance issues required to ensure the effective management of HIPE such as reviewing strategy, business plans, performance and risk for HIPE.

“Although the review identified that some improvements have been made in the area of data quality initiatives and HIPE clinical coding over the past number of years, the approaches to solving the overall information management issues of HIPE have not developed. From an information management perspective, the flow of HIPE data should be seen as one continuous process which starts at the clinical documentation stage to the point where the data is ready for use by key stakeholders to inform decision-making. This fact needs to be acknowledged and addressed by the HSE Senior Leadership team, and a coordinated approach to the governance and management of HIPE needs to be prioritised.

“Complying with the Information Management Standards will improve the quality of national health information and data, which will ultimately contribute to the delivery of safe and reliable health and social care in Ireland. Compliance with these standards will help to instil confidence in patients, clinicians and all other stakeholders that healthcare decisions are based on high-quality information, the availability of which will ultimately improve patient safety.”